The Journal of the American Paraplegia Society
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J Am Paraplegia Soc · Oct 1993
Clinical effect of alpha-1 antagonism by terazosin on external and internal urinary sphincter function.
The purpose of this investigation was to determine the effectiveness of alpha-1 blockade in the treatment of bladder outlet obstruction in the spinal cord injured (SCI) patient. We evaluated terazosin, a selective alpha-1 blocker, in 15 normotensive SCI patients. Detrusor-external sphincter dyssynergia (DESD), without obstruction of the bladder neck or prostate, was documented in all patients using video-urodynamic evaluation. ⋯ The four patients who failed to improve were documented to have an open bladder neck but obstruction at the level of the external sphincter. Our data show that alpha-1 sympathetic blockade has no effect on external sphincter function and does not significantly relieve functional obstruction caused by DESD. It was also noted that terazosin is helpful in diagnosing and treating internal sphincter (bladder neck and prostate) obstruction especially in patients who have persistent difficulty voiding after external sphincterotomy.